Abstract: Myelodysplastic syndrome (MDS) is a clonal disease derived from the hematopoietic stem cells, with a high degree of heterogeneity and complexity. The prognostic evaluation of MDS is a core problem of this disease, mainly because the complex pathogenesis (genomics, epigenetics, bone marrow microenvironment and immune factors) determines the heterogeneity of clinical characteristics (heterogeneity of age, infection, risk of bleeding, and comorbidities) and differential clinical outcome (bone marrow failure and leukemia transformation). Therefore, how to comprehensively consider various prognostic factors to establish a prognostic score system to predict the prognosis and clinical outcome of patients with MDS is very important. In the past two decades, many MDS scholars have devoted themselves to the study of various MDS prognostic scoring systems. Typical prognostic scoring systems such as the International Prognostic Scoring System (IPSS) and its revisions (IPSS-R) have been widely used. In addition, based on these new prognostic factors, the prognostic scoring system has also showed good prognostic value with the discovery of many clinical markers and molecular changes. This review summarizes the prognostic scoring system and new prognostic factors of MDS in recent years for reference in clinical practice.

Key words: myelodysplastic syndrome, prognostic, scoring, the international prognostic scoring system